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Cervical spondylosis

Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, bone spurs and other signs of osteoarthritis develop.

Cervical spondylosis is very common and worsens with age. There also appears to be a genetic component involved because some families will have more of these changes over time, while other families will develop less.

More than 90 percent of people older than age 65 have evidence of cervical spondylosis and osteoarthritis that can be seen on neck X-rays. Most of these people experience no symptoms from these problems. When symptoms do occur, nonsurgical treatments often are effective.

Symptoms
Causes
Risk factors
Complications

In most cases, cervical spondylosis causes no symptoms. When symptoms do occur, they typically affect only the neck — causing pain and stiffness.

Sometimes, cervical spondylosis results in a narrowing of the space needed by the spinal cord and the nerve roots that originate at the spinal cord and pass through the spine to the rest of your body. If the spinal cord or nerve roots become pinched, you may experience:

Tingling, numbness and weakness in your arms, hands, legs or feet

Lack of coordination and difficulty walking

Loss of bladder or bowel control

When to see a doctor

Seek medical attention if you notice sudden onset of numbness or weakness, or loss of bladder or bowel control.

Related

You'll likely first bring your concerns to the attention of your family doctor. Depending on your signs and symptoms, he or she may refer you to a physical therapist or to doctors specializing in spine disorders or orthopedic surgery.

What you can do

Before your appointment, you might want to write a list of answers to the following questions:

When did your signs and symptoms begin?

Does any type of movement or positioning make them better or worse?

Do you know if your parents or siblings experienced neck problems?

Have you ever had whiplash or any other neck injury?

Do you have other health conditions?

What medications or supplements do you regularly take?

What to expect from the doctor

A doctor who sees you for neck pain may ask:

Where exactly does your neck hurt?

Have you had previous episodes of similar pain that eventually went away?

Do your symptoms include any changes in your bladder or bowel control?

Do your symptoms include any tingling or weakness in your arms, hands, legs or feet?

During the exam, your doctor will check the range of motion in your neck. To find out if there's pressure on your spinal nerves or spinal cord, your doctor will test your reflexes and check the strength of your muscles. He or she may want to watch you walk to see if spinal compression is affecting your gait.

Imaging tests

A variety of imaging tests can provide details to guide diagnosis and treatment. Examples include:

Neck X-ray. An X-ray may show abnormalities, such as bone spurs, that indicate cervical spondylosis. It is ordered primarily as a screening test to look for rare, serious causes for neck pain and stiffness — such as tumors, infections or fractures.

Computerized tomography (CT scan). This test takes X-rays from many different directions and then combines them into a cross-sectional view of the structures in your neck. It can provide much finer details than a plain X-ray, particularly of the bones.

Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves and can produce detailed, cross-sectional images of both bone and soft tissues. This can help pinpoint areas where nerves may be getting pinched.

Myelogram. This test involves generating images using X-rays or CT scans after dye is injected into the spinal canal. The dye makes areas of your spine more visible.

Nerve function tests

In some cases, it may be helpful to determine if nerve signals are traveling properly to your muscles. Nerve function tests include:

Electromyogram (EMG). This test measures the electrical activity in your nerves as they transmit messages to your muscles when the muscles are contracting and when they're at rest. The purpose of an EMG is to assess the health of your muscles and the nerves that control them.

Nerve conduction study. For this test, electrodes are attached to your skin above the nerve to be studied. A small shock is passed through the nerve to measure the strength and speed of nerve signals.

Treatment for cervical spondylosis depends on the severity of your signs and symptoms. The goal of treatment is to relieve pain, help you maintain your usual activities as much as possible, and prevent permanent injury to the spinal cord and nerves.

Steroid injections. In some cases, injecting prednisone and a numbing agent into the area affected by cervical spondylosis may help.

Therapy

A physical therapist can teach you exercises to help stretch and strengthen the muscles in your neck and shoulders. Some people with cervical spondylosis may benefit from the use of traction, which can help provide more space within the spine if nerve roots are being pinched.

Surgery

If conservative treatment fails or if your neurological signs and symptoms — such as weakness in your arms or legs — are getting worse, you may need surgery to create more room for your spinal cord and nerve roots. This may involve removing a herniated disk or bone spurs, or it could require the removal of part of a vertebra.